Long term neurological conditions are common. For example, in NI, there are approximately 15,000 people diagnosed with epilepsy, 4,600 with multiple sclerosis, 3,700 with Parkinson’s Disease, 910 adults with inherited or acquired neuromuscular disease and 140 people with Motor Neurone Disease.
For those with neurological conditions and those caring for them, care and support is provided by a range of primary and community-based services from across the statutory and community sectors.
The Review
On 19 December 2018, in light of pressures within the neurology service, the Department published terms of reference for the Regional Review of Neurology Services. A Neurology Review Team has been established to take the review forward.
The Review Team is tasked with identifying the optimum service configuration for neurology services for the next 10-15 years.
An interim report, outlining work to date, was published on 07 October 2019. Work on the Review was paused in March 2020 in the context of the need to prioritise the response to COVID-19 pressures. The Neurology Review Team reconvened in June 2021.
Workstreams
The Review Team has identified a number of priority areas for investigation, with workstreams established for each area. Each workstream is led by a member of the Review Team, and the Review Team meets on a four weekly basis to discuss the progress of each of the workstreams. A summary of each workstream is outlined below:
First presenters - This workstream is considering the optimum approach to providing support to primary care and the processing of referrals in the context of current lengthy waiting list for outpatient appointments and an identified gap between referrals and outpatient capacity. The workstream is currently considering the potential for a Regional Neurology Advice and Guidance service whereby GPs can request advice and guidance directly from Consultants on the basis of better outcomes for those patients who can be supported by GPs.
Unscheduled care - This workstream is considering the extent of change required to provide a service in line with the Association of British Neurologists standards for unscheduled care. This includes the standard that adults admitted as a neurological emergency should see a neurology specialist within 24 hours of admission to hospital. The workstream is currently reviewing data on admissions to hospitals to enable services to be compared with those in England.
Neurology Pathway - This workstream is tasked with developing a high level Neurology Pathway in line with existing national and international guidelines, pathways and standards and informed by an assessment of gaps and constraints within current services.
Workforce - This workstream is focusing on roles, skill mix, career progression and the training of the neurological nursing workforce in the context of recognised shortages in the nursing workforce and particular challenges within neurology services. The workstream is currently developing a population based neurology nursing workforce model and the appropriate nursing workforce requirements to deliver this model. This will also include the development of an education programme to support the delivery of the workforce model.
Care Coordination - This workstream is considering how best to support patients and carers to navigate the system and streamline access to the right support. The workstream is currently undertaking a Risk Stratification exercise to obtain an improved understanding of the needs of people with neurological conditions to ensure that all neurology patients have access to the care they require in line with their level of need. In addition, the Review Team has agreed to pilot the use of the Patient Portal initially for patients with Multiple Sclerosis with a view to supported self-management.
A final report is scheduled for Summer 2023
Coproduction
The Department is committed to ensuring that the voice of service users and carers is central to the review. You can read more about the priorities that service users and carers have told us about in the report below of a workshop held on 02 July.
Further information
If you would like further information on the review, you can contact us at Neurology.Review@health-ni.gov.uk
Terms of Reference
The current neurology service model in NI has largely focused on outpatient delivery. ... more
Interim Report
The Regional Review of Neurology Services has been tasked with identifying the optimal service configuration for neurology services through to 2035 ... more
Workshop Feedback
Questions and answers to a raft of various questions on improving neurology services in NI ... more